TY - JOUR
T1 - Neuralgic Amyotrophy and Hourglass Nerve Constriction/Nerve Torsion: Two Sides of the Same Coin? A Clinical Review
AU - Granata, Giuseppe
AU - Tomasello, Fabiola
AU - Sciarrone, Maria Ausilia
AU - Stifano, Vito
AU - Lauretti, Liverana
AU - Luigetti, Marco
PY - 2024
Y1 - 2024
N2 - Neuralgic amyotrophy, also called Parsonage–Turner syndrome, in its classic presentation is a brachial plexopathy or a multifocal neuropathy, involving mainly motor nerves of the upper limb with a monophasic course. Recently, a new radiological entity was described, the hourglass constriction, which is characterized by a very focal constriction of a nerve, or part of it, usually associated with nerve thickening proximally and distally to the constriction. Another condition, which is similar from a radiological point of view to hourglass constriction, is nerve torsion. The pathophysiology of neuralgic amyotrophy, hourglass constriction and nerve torsion is still poorly understood, and a generic role of inflammation is proposed for all these conditions. It is now widely accepted that nerve imaging is necessary in identifying hourglass constrictions/nerve torsion pre-surgically in patients with an acute mononeuropathy/plexopathy. Ultrasound and MRI are useful tools for diagnosis, and they are consistent with intraoperative findings. The prognosis is generally favorable after surgery, with a high rate of good motor recovery.
AB - Neuralgic amyotrophy, also called Parsonage–Turner syndrome, in its classic presentation is a brachial plexopathy or a multifocal neuropathy, involving mainly motor nerves of the upper limb with a monophasic course. Recently, a new radiological entity was described, the hourglass constriction, which is characterized by a very focal constriction of a nerve, or part of it, usually associated with nerve thickening proximally and distally to the constriction. Another condition, which is similar from a radiological point of view to hourglass constriction, is nerve torsion. The pathophysiology of neuralgic amyotrophy, hourglass constriction and nerve torsion is still poorly understood, and a generic role of inflammation is proposed for all these conditions. It is now widely accepted that nerve imaging is necessary in identifying hourglass constrictions/nerve torsion pre-surgically in patients with an acute mononeuropathy/plexopathy. Ultrasound and MRI are useful tools for diagnosis, and they are consistent with intraoperative findings. The prognosis is generally favorable after surgery, with a high rate of good motor recovery.
KW - anterior interosseous nerve palsy
KW - hourglass-like constriction
KW - nerve torsion
KW - neuralgic amyotrophy
KW - neurolysis
KW - posterior interosseous nerve palsy
KW - radial nerve palsy
KW - anterior interosseous nerve palsy
KW - hourglass-like constriction
KW - nerve torsion
KW - neuralgic amyotrophy
KW - neurolysis
KW - posterior interosseous nerve palsy
KW - radial nerve palsy
UR - http://hdl.handle.net/10807/298963
U2 - 10.3390/brainsci14010067
DO - 10.3390/brainsci14010067
M3 - Article
SN - 2076-3425
VL - 14 (67)
SP - 1
EP - 11
JO - Brain Sciences
JF - Brain Sciences
ER -